Fetal physiology during maternal surgery or diagnosis

Abstract

The occurrence of hypercapneic acidosis in a fetus during a laparoscopic procedure carried out on a pregnant female, is prevented or ameliorated by inclusion in or addition to the carbon dioxide insufflation gas, of a nitric oxide donor, e.g., ethyl nitrite. Administration of nitric oxide donor in insufflation gas causes increase in fetal cerebral oxygenation.

1 . A method of preventing or ameliorating the presence of hypercapneic acidosis or hypercapnia or acidosis in a fetus of a pregnant female during a laparoscopic procedure carried out on the pregnant female, comprising, in the course of the laparoscopic procedure, administering to said female an insufflating gas comprising carbon dioxide and an amount of a nitric oxide donor effective to prevent or ameliorate the occurrence of hypercapnia and acidosis in the fetus. 
     
     
         2 . The method of  claim 1  where the nitric oxide donor is ethyl nitrite. 
     
     
         3 . A method for increasing fetal cerebral oxygenation under conditions of fetal stress, comprising administering to a pregnant female an insufflating gas comprising an amount of nitric oxide donor effective to increase fetal cerebral oxygenation. 
     
     
         4 . The method of  claim 3  where the nitric oxide donor is ethyl nitrite. 
     
     
         5 . The method of  claim 4  where the ethyl nitrite is present in the insufflating gas in an amount ranging from 1 to 1,000 ppm. 
     
     
         6 . The method of  claim 3  where the insufflating gas consists essentially of carbon dioxide and from 1 to 1,000 pm ethyl nitrite. 
     
     
         7 . The method of  claim 6  where the insufflating gas consists essentially of carbon dioxide and from 50 to 200 ppm ethyl nitrite. 
     
     
         8 . A method for increasing fetal cerebral oxygenation under conditions of fetal stress comprising administering via inhalation to a female pregnant with the fetus supplemental oxygen and an amount of nitric oxide donor effective to increase fetal cerebral oxygenation. 
     
     
         9 . The method of  claim 8  where the nitric oxide donor is ethyl nitrite which is administered at a concentration of 1 to 100 ppm. 
     
     
         10 . A method of preventing or ameliorating the presence of hypercapnia or acidosis or hypercapneic acidosis in a fetus of a pregnant female comprising administering via inhalation to the pregnant female an amount of nitric oxide donor effective to prevent or ameliorate the occurrence of hypercapnia and acidosis in the fetus. 
     
     
         11 . The method of  claim 10  where the nitric oxide donor is ethyl nitrite which is administered at a concentration of 1 to 100 ppm.